东南大学医学影像学专业(本科五年制)教学计划的构思

修订东南大学医学影像学专业本科五年制教学计划：坚持遵循教育教学的基本规律，坚持知识、能力、素质协调发展和综合提高的原则和方法。打通公共基础，建立通识教育基础平台：拓宽学科基础课，增加基础学科选修课；凝炼专业主干课程，加强临床实践环节；前期趋同，宽口径专业培养，后期分流灵活专业方向，实现专才向通才、教学向教育和传授向学习的转变。培养和造就高层次医学影像学专业人才，以适应影像设备迅猛发展的需要，适应影像学科建设的需要，适应培养新世纪医学影像学专业人才的需要。     

人胎儿前庭器超微结构的观察

对人胎儿前庭器超微结构的研究,国内外报道甚少。本文对18至36周人胎儿颞骨10具进行了扫描电镜和透射电镜的观察,并对应用Surface preparation法制做人胎儿前庭器标本的方法进行了探讨。本文观察所见:豚鼠平衡斑的生理状态与人胎儿很近似,体面积比人胎儿平衡斑小,感觉毛长,细胞排列更整齐。28周以后的胎儿因前庭周围骨质变硬,制做标本时可以分别取出两囊斑和壶腹嵴。     

颈动脉粥样硬化及其相关因素的探讨

目的:探讨颈动脉粥样硬化与相关危险因素的关系。方法:对200例研究对象的颈总动脉内中膜厚度(IMT)和颈动脉粥样硬化斑块进行超声检测,根据TMT分为IMT≤0.99mm组和IMT≥1.00mm组,并记录胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、载脂蛋白AI(APOAI)、载脂蛋白B_(100)(APOB_(100))、脂蛋白(α)[LP(α)]、纤维蛋白原(Fbg)、血糖(BG)、血压(BP)、体重指数(BMI)、吸烟指数及年龄等指标。结果:随着IMT增厚,颈动脉粥样硬化斑块发生率增加(P<0.01),IMT与TC、LDL-c、APOB_(100)、LP(α)、Fbg、SBP、吸烟指数及年龄呈明显正相关(P<0.05～0.01)。结论:颈动脉粥样硬化与TC、LDL-c、APOB_(100)、LP(α)、Fbg、SBP及嗜烟和年龄密切相关。定期超声监测颈动脉及检查相应危险因素对防治颈动脉粥样硬化有一定的实用参考价值。     

Intussesception after jejunoileal bypass as diagnosed by ultrasound

Eighty patients who had undergone jejunoileal bypass for morbid obesity were examined by ultrasound at their routine follow-up visits to the clinic. Ultrasonographic evidence of intestinal intussusception was found in 15 patients (19%). Two of these patients were asymptomatic. Ultrasonographic findings were confirmed by operation in 6 patients (5 with intussusception, 1 negative).     

高频超声在小儿腹股沟斜疝手术治疗中的价值

目的　探讨高频超声检测小儿腹股沟斜疝腹股沟管扩张程度对于选择手术方式的价值。　方法　回顾分析 4 88例施行单纯疝囊高位结扎手术的小儿腹股沟斜疝超声检测的腹股沟管扩张最大内径 ,分组追踪其术后斜疝复发率。　结果　腹股沟管扩张最大内径 >1.5 cm的一组病例术后复发率明显增高。　结论　高频超声检测腹股沟管扩张最大内径 >1.5 cm的小儿腹股沟斜疝有必要行斜疝修补术 ,减少复发率 ,为临床医师提供有价值的客观指标     

Effect of prostaglandin E1 on graft function of kidneys from living related donors

Prostaglandin E₁ (PGE₁) was used in renal transplant recipients with living related donors. The drug was given intravenously from day 1 to day 7 after transplantation at a dose of 40 µg/kg twice a day. A total of 45 patients were studied divided into two groups: 25 patients were treated with PGE₁ (group B) and the remaining 20 patients did not receive the drug (group A). In group B, 24-h creatinine clearance (Ccr) was 66 ± 12.8 ml/min compared with 40.3 ± 13.4 ml/min in group A on the fifth postoperative day (P < 0.05). Urinary levels of N-acetyl-β-d -glucosaminidase (NAG) and serum levels of platelet factor 4 (PF4) in group B were significantly lower than in group A. On the fourth postoperative day, the urinary excretion of thromboxan B₂ (TxB₂) in group A was higher than in group B, but not significantly (5.1 ± 3.0 ng/day and 2.8 ± 1.1 ng/day, respectively). Acute rejection occurred in four patients in group B and in 10 patients (40%) in group A. The percentage of Leu2a-positive lymphocytes in group B was higher than in group A. We conclude that postoperative administration of PGE₁ improves graft function in kidneys from living related donors.     

Non-invasive dynamic assessment of the elasticity of intracranial structures

The dynamics of the speed of transcranial propagation of ultrasonic impulses has been established in humans. The possibility of detecting the changes in mechanical state of intracranial structures by dynamic measurement of the time of transcranial propagation of ultrasonic impulses (TUPT) has been ascertained for 10 healthy persons and 11 patients with different neurological pathology. The cerebrospinal fluid pressure (CSFP) was simultaneously monitored for 4 of the patients. Spontaneous fluctuations in TUPT and the changes caused by jugular veins, inferior vena cava compression, hyperventilation and temporary retention of breathing were detected for all investigated subjects. Spontaneous TUPT changes in the range of 0.25-0.85 x 10(-4) of initial mean value, which are related with cardiac and respiratory cycles, have been found in healthy persons while in patients they ranged from 0.07 x 10(-4) to 4.5 x 10(-4) of mean time. In healthy persons bilateral jugular vein compression leads to a decrease in TUPT by 1.8-3.0 x 10(-4), while the compression of inferior vena cava gives an increase in TUPT by 1.6-2.6 x 10(-4). Changes in TUPT during these maneuvers in neurological patients were found to be of different amplitude and direction. The rise of CSFP by 8.4-20.2 mmHg (mean 12.4 mmHg) was observed in 4 investigated patients during the compression of jugular veins or during the inferior vena cava compression, while the changes in TUPT obtained during each of such maneuvers were of opposite character. The results suggest that dynamic evaluation of acoustic impedance of intracranial system reflects the changes in the mechanical state of brain parenchyma.     

Surgical relevance of diagnostic imaging techniques in pretherapeutic staging of carcinoma of the esophagus, stomach, colon and rectum

Summary. The increasing spectrum of therapeutic options for tumors of the gastrointestinal tract has resulted in a refinement of the pretherapeutic diagnostic strategies. The diagnostic approach in surgical institutions that are focused on primary surgical resection will therefore be much less sophisticated than in institutions who propose a selective therapeutic approach based on the pretherapeutic tumor stage and prognostic parameters. Pretherapeutic assessment of the depth of tumor infiltration, i. e. the T-category, is essential because most further diagnostic and therapeutic decisions are based on this information. This can today be achieved with a high degree of accuracy by endoscopy and endoscopic ultrasonography. Early T-stages (T1–2) are usually an indication for primary surgical resection and, after exclusion of distant metastases, no further diagnostic studies are required. In patients with locally advanced esophageal, gastric or rectum tumors (T3–4) multimodal therapeutic concepts should be considered. This usually requires additional diagnostic studies. None of the available diagnostic imaging modalities today allows satisfactory pretherapeutic assessment of lymph node metastases. The assumed nodular status should therefore currently not influence therapeutic decisions. Essential is, however, the assessment of distant metastases, since the documentation of distant tumor spread will change the therapeutic approach to a palliative situation. Detailed histologic and molecular-biologic assessment of tumor characteristics is growing in importance. This not only provides therapeutically relevant information regarding tumor grading, but opens the door towards a modern molecular diagnostic approach. It can be expected that in the near future a vast amount of relevant prognostic information can be obtained from endoscopic tumor biopsies, which may soon alter our therapeutic concepts.      

福田4500型B超软故障检修与分析

通过福田4500型B超软故障检修与分析，介绍了该机故障检修分析过程及造成该故障的原因。